OrganizationActive
Charisse Ali, LLC a Lasting Impression
NPI 1063008670 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Ashtabula, OH
Provider details
- NPI number
- 1063008670
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Charisse Ali, Ceo/Owner(440) 319-2078
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Practice location
1440 W Prospect Rd
Ashtabula, OH 44004-6668
Phone: (440) 319-2078
Fax: (440) 998-5820
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 548
Ashtabula, OH 44005-0548
Registry dates
- Enumerated
- 2020-12-17
- Last updated
- 2020-12-17
- Certified
- 2020-12-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.